A medical information system for monitoring respiratory function and related nonlinear dynamics

In this paper the nonlinear effects in the respiratory systems at low frequencies are measured and evaluated in healthy children and healthy adults. To this aim forced oscillations technique (FOT) has been used to non-invasively measure the lung tissue mechanics. FOT does not require any special effort from the patient in contrast with standardized tests where maneuvers are necessary. Hence, FOT is an ideal lung function test for extreme ages, more specifically children and elderly, given the simpleness of measurement technique. Hitherto, measurements at low frequencies (i.e. close to the breathing frequency similar to 0.3 Hz) have been invasively performed in sacrificed animals and on anesthetized humans. Here we measure in the frequency interval 0.1-2 Hz a total number of 94 volunteers (37 adults with ages between 25-35 years and 57 children with ages between 8-11 years). To evaluate the nonlinear contributions of the respiratory tissue, a novel T-index has been introduced. We have tested the hypothesis whether the nonlinear distortions are changing with growth/development of the respiratory tree and aim to quantify its dependence to biometric values. The results obtained indicate that the proposed index can differentiate between the two analyzed groups and that there is a dependence to age, height and weight. A medical information system may use this information to update predictions of respiratory function and provide aid in decision-making process of drug therapy

Pain detection with bioimpedance methodology from 3-dimensional exploration of nociception in a postoperative observational trial

Although the measurement of dielectric properties of the skin is a long-known tool for assessing the changes caused by nociception, the frequency modulated response has not been considered yet. However, for a rigorous characterization of the biological tissue during noxious stimulation, the bioimpedance needs to be analyzed over time as well as over frequency. The 3-dimensional analysis of nociception, including bioimpedance, time, and frequency changes, is provided by ANSPEC-PRO device. The objective of this observational trial is the validation of the new pain monitor, named as ANSPEC-PRO. After ethics committee approval and informed consent, 26 patients were monitored during the postoperative recovery period: 13 patients with the in-house developed prototype ANSPEC-PRO and 13 with the commercial device MEDSTORM. At every 7 min, the pain intensity was measured using the index of Anspec-pro or Medstorm and the 0-10 numeric rating scale (NRS), pre-surgery for 14 min and post-anesthesia for 140 min. Non-significant differences were reported for specificity-sensitivity analysis between ANSPEC-PRO (AUC = 0.49) and MEDSTORM (AUC = 0.52) measured indexes. A statistically significant positive linear relationship was observed between Anspec-pro index and NRS (r(2) = 0.15, p < 0.01). Hence, we have obtained a validation of the prototype Anspec-pro which performs equally well as the commercial device under similar conditions

Detection and evaluation of events in EEG dynamics in post-surgery patients with physiological-based mathematical models

As part of the new directions for vision and mission of Europe, patient well-being and healthcare become core features of a modern and prosperous society. That is, healthcare costs are optimized towards patient benefit and sideways effects such as cost-related reduction in medication, in frequency of post-operatory interventions, in recovery times and in comorbidity risk. In this paper, we address the incidence of events related to stroke, epileptic seizures and tools to possibly predict their presence from Electroencephalography (EEG) signal acquired in post-surgery patients. Wavelet analysis and spectrogram indicate graphically changes in the energy content of the EEG signal. Physiologically based neuronal dynamic pathway is used to derive fractional order impedance models. Nonlinear least squares identification technique is used to identify model parameters, with results suggesting parameter redundancy. There is a significant difference in model parameter values between EEG signal with/-out events

THE INVOLVEMENT OF INFORMATION TECHNOLOGY IN THE OPTIMAL FUNCTIONING OF ELECTRIC DRIVE SYSTEMS

The implementation of sustainable development in Romania and the abrupt increase of prices for fussil fuels have imposed more serious activies for the examination of the energy consumption in different industrial sectors. Here, the asynchronous electric motors represent the main loads; therefore the energy consumption in electrical drives has to be careffuly watched. The achievement of various procedures to improve energy efficiency, compulsory imposes an energy balance who aims to illustrate the existent profile of energy consumption . The study presents an industry case study about estimation of operating systems functioning that use variable speed motors, highlighting the necessity and appropriateness of using informatic instruments that provide calculations needed to elaborate energy balance and by that, to determine the measures to increase energetic efficiency.energy efficiency, electric drive, energy balance, power factor, informatic instruments

A low computational cost, prioritized, multi-objective optimization procedure for predictive control towards cyber physical systems

Cyber physical systems consist of heterogeneous elements with multiple dynamic features. Consequently, multiple objectives in the optimality of the overall system may be relevant at various times or during certain context conditions. Low cost, efficient implementations of such multi-objective optimization procedures are necessary when dealing with complex systems with interactions. This work proposes a sequential implementation of a multi-objective optimization procedure suitable for industrial settings and cyber physical systems with strong interaction dynamics. The methodology is used in the context of an Extended Prediction self-adaptive Control (EPSAC) strategy with prioritized objectives. The analysis indicates that the proposed algorithm is significantly lighter in terms of computational time. The combination with an input-output formulation for predictive control makes these algorithms suitable for implementation with standardized process control units. Three simulation examples from different application fields indicate the relevance and feasibility of the proposed algorithm

COMPUTER METHODS FOR ANALYSIS AND OPTIMIZATION OF ENERGY COMSUMPTIONS

The implementation of sustainable development in Romania and the abrupt increase of prices for fussil fuels have imposed more serious activies for the examination of the energy consumption in different industrial sectors. Here, the asynchronous electric menergy efficiency, electric drive, energy balance, power factor, informatic instruments.

An open source patient simulator for design and evaluation of computer based multiple drug dosing control for anesthetic and hemodynamic variables

We are witnessing a notable rise in the translational use of information technology and control systems engineering tools in clinical practice. This paper empowers the computer based drug dosing optimization of general anesthesia management by means of multiple variables for patient state stabilization. The patient simulator platform is designed through an interdisciplinary combination of medical, clinical practice and systems engineering expertise gathered in the last decades by our team. The result is an open source patient simulator in Matlab/Simulink from Mathworks(R). Simulator features include complex synergic and antagonistic interaction aspects between general anesthesia and hemodynamic stabilization variables. The anesthetic system includes the hypnosis, analgesia and neuromuscular blockade states, while the hemodynamic system includes the cardiac output and mean arterial pressure. Nociceptor stimulation is also described and acts as a disturbance together with predefined surgery profiles from a translation into signal form of most commonly encountered events in clinical practice. A broad population set of pharmacokinetic and pharmacodynamic (PKPD) variables are available for the user to describe both intra- and inter-patient variability. This simulator has some unique features, such as: i) additional bolus administration from anesthesiologist, ii) variable time-delays introduced by data window averaging when poor signal quality is detected, iii) drug trapping from heterogeneous tissue diffusion in high body mass index patients. We successfully reproduced the clinical expected effects of various drugs interacting among the anesthetic and hemodynamic states. Our work is uniquely defined in current state of the art and first of its kind for this application of dose management problem in anesthesia. This simulator provides the research community with accessible tools to allow a systematic design, evaluation and comparison of various control algorithms for multi-drug dosing optimization objectives in anesthesia

Closed-loop control of anesthesia : survey on actual trends, challenges and perspectives

Automation empowers self-sustainable adaptive processes and personalized services in many industries. The implementation of the integrated healthcare paradigm built on Health 4.0 is expected to transform any area in medicine due to the lightning-speed advances in control, robotics, artificial intelligence, sensors etc. The two objectives of this article, as addressed to different entities, are: i) to raise awareness throughout the anesthesiologists about the usefulness of integrating automation and data exchange in their clinical practice for providing increased attention to alarming situations, ii) to provide the actualized insights of drug-delivery research in order to create an opening horizon towards precision medicine with significantly improved human outcomes. This article presents a concise overview on the recent evolution of closed-loop anesthesia delivery control systems by means of control strategies, depth of anesthesia monitors, patient modelling, safety systems, and validation in clinical trials. For decades, anesthesia control has been in the midst of transformative changes, going from simple controllers to integrative strategies of two or more components, but not achieving yet the breakthrough of an integrated system. However, the scientific advances that happen at high speed need a modern review to identify the current technological gaps, societal implications, and implementation barriers. This article provides a good basis for control research in clinical anesthesia to endorse new challenges for intelligent systems towards individualized patient care. At this connection point of clinical and engineering frameworks through (semi-) automation, the following can be granted: patient safety, economical efficiency, and clinicians' efficacy

Bioimpedance sensor and methodology for acute pain monitoring

The paper aims to revive the interest in bioimpedance analysis for pain studies in communicating and non-communicating (anesthetized) individuals for monitoring purpose. The plea for exploitation of full potential offered by the complex (bio)impedance measurement is emphasized through theoretical and experimental analysis. A non-invasive, low-cost reliable sensor to measure skin impedance is designed with off-the-shelf components. This is a second generation prototype for pain detection, quantification, and modeling, with the objective to be used in fully anesthetized patients undergoing surgery. The 2D and 3D time-frequency, multi-frequency evaluation of impedance data is based on broadly available signal processing tools. Furthermore, fractional-order impedance models are implied to provide an indication of change in tissue dynamics correlated with absence/presence of nociceptor stimulation. The unique features of the proposed sensor enhancements are described and illustrated here based on mechanical and thermal tests and further reinforced with previous studies from our first generation prototype